Organization Active NPI

Doug S Clouse MD PLC

  • Specialist
  • Chandler, AZ
National Provider Identifier
1124357439
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
37427 Issued in AZ
Legal business name
DOUG S CLOUSE MD PLC
Practice address
2450 S Gilbert Rd Ste 109
Chandler, AZ 85286-1594
Phone
(480) 899-4333
Fax
(480) 899-7219
NPI assigned
Dec 15, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Douglas S Clouse, MD
Title
Owner
Phone
(480) 899-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 37427 AZ Primary

Addresses

Primary practice location

2450 S Gilbert Rd Ste 109
Chandler, AZ 85286-1594

Mailing address

2450 S Gilbert Rd Ste 109
Chandler, AZ 85286-1594
Phone (480) 899-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100330001326 AZ Part B Supplier - Clinic/Group Practice 9537295456 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: Chandler, AZ; Gold Canyon, AZ; Kingman, AZ; Laveen, AZ; Maricopa, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3345 S Val Vista Dr
Gilbert, AZ 85297
Phone (480) 857-7123

3345 S Val Vista Dr
Ste 107110
Gilbert, AZ 85297
Phone (480) 725-9777

3636 N Stockton Hill Rd
Ste 3
Kingman, AZ 86409

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674691200000",
    "number": "1124357439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 S GILBERT RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861594",
            "telephone_number": "480-899-4333",
            "fax_number": "480-899-7219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S GILBERT RD STE 109",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861594",
            "telephone_number": "480-899-4333",
            "fax_number": "480-899-7219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUG S CLOUSE MD PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-15",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "CLOUSE",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-899-2101",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AZ",
            "license": "37427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.